Abstract
To investigate whether peripheral blood biomarkers predict the outcome of anti-PD-1 antibody treatment for head and neck squamous cell carcinoma (HNSCC). Patients treated with nivolumab for platinum-refractory recurrent or metastatic HNSCC were retrospectively reviewed. Fifty-three patients treated between April 2017 and March 2018 were included in the study. The median progression-free survival (PFS) and overall survival (OS) were 2.5 and 8.7 months, respectively. In the univariate analysis, performance status (PS) ≥ 3, relative neutrophil count ≥ 0.65, relative lymphocyte count ≥ 0.17, and relative eosinophil count (REC) ≥ 0.015 were significantly associated with both PFS and OS. On multivariate analysis, PS ≥ 3 and REC ≥ 0.015 were significantly associated with PFS and OS. Low REC and poor PS were independent poor prognostic factors for both PFS and OS in patients with recurrent or metastatic HNSCC treated with nivolumab.
Highlights
The introduction of immune checkpoint inhibitors (ICIs) targeting cytotoxicT-lymphocyte antigen 4 (CTLA-4) and programmed cell death-1 (PD-1)/programmed death ligand 1(PD-L1) has caused a breakthrough in the treatment of various cancers
Heppt et al reported that C-reactive protein (CRP), relative eosinophil count (REC), and lactate dehydrogenase (LDH) predicted overall survival (OS) of uveal melanoma treated with ICIs [2]
Seven patients were excluded because one had adenocarcinoma of the submandibular gland, two did not undergo initial evaluation of treatment response because insufficient time had elapsed after nivolumab administration at the time of data collection, and four lacked performance status (PS) information
Summary
The introduction of immune checkpoint inhibitors (ICIs) targeting cytotoxicT-lymphocyte antigen 4 (CTLA-4) and programmed cell death-1 (PD-1)/programmed death ligand 1(PD-L1) has caused a breakthrough in the treatment of various cancers. CheckMate 141, a phase III randomized control study, reported that the anti-PD-1 antibody nivolumab, compared to conventional chemotherapy, improved the overall survival (OS) of platinum-refractory recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) [1]. Nivolumab has been used as a standard second-line treatment for recurrent or metastatic HNSCC. The definitive factors predicting treatment response and survival of head and neck cancer treated with nivolumab have not been clarified. Several authors reported that baseline peripheral blood biomarkers predicted treatment outcome for several types of cancers treated with ICIs [2,3,4,5,6]. Heppt et al reported that C-reactive protein (CRP), relative eosinophil count (REC), and lactate dehydrogenase (LDH) predicted OS of uveal melanoma treated with ICIs [2]
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